Effectiveness of Neurological Physiotherapy Interventions in Post-stroke Motor Rehabilitation: A Systematic Review

Stroke frequently results in persistent upper-limb, lower-limb, and gait impairments that restrict independence and quality of life. Neurological physiotherapy aims to enhance post-stroke motor recovery through task-specific practice, strengthening, sensory-motor retraining, feedback, neuroplasticity stimulation, and activity-based rehabilitation. This systematic review aimed to evaluate the effectiveness of neurological physiotherapy interventions in post-stroke motor rehabilitation and to summarize intervention characteristics, outcomes, methodological quality, and risk of bias. A systematic search was conducted across electronic databases, including PubMed, Google Scholar, ScienceDirect, and the Cochrane Library, to identify randomized controlled trials (RCTs) published from 2015 onward and available as full-text articles. After duplicate removal and screening, 47 full-text articles were assessed, and 11 RCTs were included. Data were extracted on study design, participants, stroke phase, intervention type, comparator, outcomes, numerical findings, and adverse events. Findings were synthesized narratively due to heterogeneity in intervention type, recovery phase, treatment dose, and outcome measures; no meta-analysis was performed. The review included functional strength training (FST), movement performance therapy, virtual reality (VR), robot-assisted rehabilitation, action observation therapy, mirror therapy, electrical stimulation, brain-computer interface (BCI)-assisted therapy, and walking-based interventions. Most interventions improved motor or functional outcomes, although superiority over conventional or dose-matched therapy was inconsistent. Overall, individualized, progressive, task-oriented neurological physiotherapy remains central to post-stroke motor recovery, with technology-assisted approaches offering additional value when integrated with meaningful functional practice.